Dechen Tshomo

The national referral hospital generates about 106kgs of infectious and 316kgs of non-infectious waste every day.

But there is confusion as to who should remove those wastes from the hospital.

With limited space to store at its storage house above the mortuary in Changzamtok, red and green degradable plastic bags pile up if the waste is not removed for a few days.

The hospital had waste disposal issues as collection became irregular with frequent breakdown of the Greener Way’s garbage collection trucks, hospital officials claimed.

The hospital took the matter into their own hands. Starting September, the hospital has been using its own vehicle to dump the waste four days a week, in addition to Greener Way’s three times a week.

The Chief Executive Officer of Greener Way, Karma Yonten said there were times when they were unable to send their vehicle on the scheduled time due to various reasons. However, he said, Greener Way made sure the collection is made in the next few days and make up for the missed day.

“This is not the job a municipal solid waste service provider has to do because it is clearly mentioned in the contract that we are mandated to collect only municipal solid waste,” he said.

By no way, he said garbage generated in the hospital should be treated as municipal solid waste because it is bio-hazardous. “And there are a lot of associated risks.”

He said Greener Way continued providing waste collection service to the hospital because that was how it was practiced when the waste management was done by the thromde.

“We are rendering the service to JDWNRH as support. Medical waste is totally different and it should not be going with the municipal solid waste,” he said. “Even in the National Environment Commission’s solid waste regulation, it is clearly mentioned that it is different.”

Earlier, before the thromde outsourced the waste collection to Greener Way, the thromde collected waste from the hospital every day along with households waste.

JDWNRH’s Medical Superintendent Dr Gosar Pemba said once the waste is sterilised by autoclaving, it is not medical waste. “We are treating infectious waste before disposing it to the landfill.”

“In any city, the hospital is supposed to treat its own waste and give it to the municipal for disposal. The hospital is located within the municipal area so we belong to the municipal.”

Every morning, the hospital’s ward boys and cleaners collect the waste from the hospital and move them to the storage house.

Krishna Kumar Gurung, hospital’s storage house incharge said the infectious waste is autoclaved every day and keep it ready to be transported to the landfill.

He said the general waste is segregated. Papers are shredded, sharps like needles, blades and other glass articles and pathological waste like placentas, body parts and other body secretions and excretions are incinerated at Hejo.

Karma Yonten said not all infectious wastes are autoclaved all the time. “As handlers, we have faced it. My people are exposed to threat and who is going to be accountable if they get infected. I have to be answerable if something goes wrong.”

In many forums and meetings, he said hospital officials always claim that they autoclave the infectious waste like gauze and dry waste. “Medical waste is much bigger than what they are talking about. The hospital has failed in treating their garbage.”

For medical waste, he said there should be a common centre for bio-medical waste treatment and disposal facility and a proper sanitary landfill.

“JDWNRH is always blaming Greener Way as a service provider but have they done their part?” he said. “Everybody should be responsible for their own garbage. For municipal solid waste, Greener Way and public are doing their part.”

He said hospitals and automobile areas have to do their part as well. “They cannot expect the government to provide them with extra service sharing the perks that households are entitled to. They cannot demand the same because they are commercial.”

Greener Way wants to drop collecting waste from the hospital and automobile workshops because of risks. “We cannot handle it because professionally that is not the way to handle such waste. They should do it because their people are trained and they have enough budget.”

“Just contracting your job by providing small amount of service collection fee does not qualify them in saying that the garbage had to be totally managed by the private sector,” he said, “We have to work together. We are trying to create a recycle industry and be a better service provider, but we are at loggerhead with many agencies. It is discouraging.”

Of the 13 collection trucks, Greener Way is catering to the south and central zones of the city with nine trucks. The rest are on and off the road. “But, things have improved a lot,” he said.

Waste from the hospital and automobile workshop is directly discarded to the landfill. “We don’t let our people handle it because it is dangerous.”

With the increasing number of patients, the quantity of garbage the hospital generates has also been on the rise.

Krishna Kumar Gurung said the Greener Way collection was irregular earlier. “When we call them, they say their vehicle has broken down and sometimes they say they have sent the vehicle.”

To avoid confusion he started recording the number of collections made by Greener Way along with date and time and collected the driver’s signature on the register. “This creates transparency.”

He said if people visited the storage house they would see that it has improved. “Earlier, we see waste overflowing.”

Outsiders disposing their waste near the storage house is another issue. “When we come in the morning, we find waste scattered on the ground. They don’t even dispose of it inside the bins.”

A Thromde official said according to the contract between the thromde and Greener Way, the service provider is mandated to collect municipal solid waste and there is nothing mentioned about medical waste. “We haven’t thought about medical waste when we signed the contract.”

The official said Greener Way wanted to stop waste collection from the hospital. “Maybe it is because the quantity is huge.” However, the official said the treated waste is disposed along with other waste at the landfill.

According to the Waste Prevention and Management Regulation, infectious waste like contaminated gauze, cotton and other materials should be autoclaved, shredded or render non-infectious through chemical disinfection and disposed of along with general wastes.